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GENESIS PEDIATRICS LLC NPI 1306943527


NPI Information

NPI: 1306943527
Provider Name: GENESIS PEDIATRICS, LLC

Doing Business As: GENESIS PEDIATRICS

Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 33D0718906

Address:
900 ELMGROVE ROAD
ROCHESTER, NY
ZIP 14624
Phone: (585) 426-4100
Get Directions

GENESIS PEDIATRICS, LLC is a pediatrics in Rochester, NY. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. GENESIS PEDIATRICS, LLC NPI is 1306943527. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Genesis Pediatrics.

The provider's business location address is:

900 ELMGROVE ROAD
ROCHESTER, NY
ZIP 14624-236
Phone: (585) 426-4100
Fax: (585) 426-3701

The provider's authorized official is Catherine A Goodfellow .
The authorized official title is Member/owner and has the following contact phone number (585) 426-4100.

The CLIA number assigned to this NPI record is 33D0718906 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/20/2006 and was last updated on 2/5/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
101414680MEDICAIDNEW YORK
200188076590OTHERAETNA US HEALTHCARE
3161328076OTHERTRICARE REGION 1

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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